Long-term follow-up of patients with gastric outlet obstruction related to peptic ulcer disease treated with endoscopic balloon dilatation and drug therapy

Endoscopic balloon dilatation without fluoroscopy for treating gastric outlet obstruction because of benign etiologies

“…Earlier studies on balloon dilatation had dismal results in patients with GOO, with a high frequency of repeat dilatations and up to 40-50% patients requiring surgery [7,15]. However, a better understanding of the pathophysiology of peptic ulcer disease, the availability of proton pump inhibitors, and the eradication of H. pylori have considerably improved the results of EBD, with success rates of up to 85% and with complications such as bleeding and perforation occurring in less than 10% of the cases [7][8][9][10][11][12][13][14]16]. Similar to earlier studies, we also found that balloon dilatation was effective in 91% of the patients with peptic ulcer-related GOO and perforation requiring surgery was encountered in one patient (9%).…”

Adverse events of upper GI endoscopy

“…Endoscopic balloon dilation for benign gastric outlet obstruction has been associated with perforation rates as high as 7.4%. [79][80][81][82][83][84] Risk factors for perforation include dilation in the setting of active ulceration 83 and dilation with balloons greater than 15 mm in diameter. 80,82,83,85 Graded dilation with stepwise increase of balloon size has been suggested to help reduce the risk of perforation.…”

Complications of Peptic Ulcer Disease

“…Such studies suggest that endoscopic balloon dilatation in gastric outlet obstruction related to PUD does not achieve long-term remission and most patients require surgery, but recently published analyses confirmed that benign pyloric stenosis can be readily treated with endoscopic balloon dilatation and should be the first-line therapy with a favorable long-term outcome [9,10]. …”